West London Mental Health NHS Trust’s CAMHS and Schools Link Pilot started running in March 2016 and formed part of NHS England and the Department of Health’s initiative, arising from the Future in Mind document. Hammersmith and Fulham was selected as one of the pilot sites, and the aim of the project was to raise awareness and improve knowledge of mental health issues amongst staff within schools in the borough

Co-Production

From start: No

During process: Yes

In evaluation: No

Evaluation

Peer: Yes

Academic: No

PP Collaborative: Yes

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What We Did

West London Mental Health NHS Trust’s CAMHS and Schools Link Pilot started running in March 2016 and formed part of NHS England and the Department of Health’s initiative, arising from the Future in Mind document. This was an exceptionally important project considering that children’s mental health has long been in crisis – one in 10 children suffer from depression, anxiety or another diagnosable mental health problem, and 75% of mental illness starts before the age of 18. Our project was unique as it provided participating schools with a CAMHS link clinician who worked closely with a mental health lead in each school. We also worked closely with The Anna Freud Centre, which led 2-day training for the lead clinicians and school staff. Each clinician was allocated a half day per week usually used as 2 hours in the school, with travel time, training preparation and administration making up the rest of the time.

Hammersmith and Fulham was selected as one of the pilot sites, and the aim of the project was to raise awareness and improve knowledge of mental health issues amongst staff within schools in the borough. Four primary schools, eight secondary schools, one secondary alternate provision (PRU) and one specialist school for children with severe learning disabilities formed the pilot, which was rolled out to improve joint working between school settings and children and young people’s mental health services.

Together, the CAMHS link clinician and the school’s mental health lead delivered a range of training workshops to up skill staff. These tackled media and mental health, anxiety, self-esteem, resilience, body image, anger management and autism spectrum disorder. Our clinicians also offered schools with drop-in sessions for teachers and other school staff focusing on many aspects of school-related mental health issues, as well as sessions on mindfulness and positive parenting. Staff were given constant support and consultation, and as a result felt better informed about mental health. We made a different through this project by educating a key workforce in direct contact with children, day in, day out. By venturing into this space we have shown a commitment to reaching children who may be in need, but had to initially support teachers to begin this process.

Our CAMHS clinicians also worked to support the development of the school’s mental health policy and raise awareness of mental health resources available in the borough. This has made a real difference to teachers who otherwise felt ill-equipped to deal with mental health issues in the classroom, but were then exposed to a guideline they could work to in order to take care of their students. In turn, this has allowed West London Mental Health NHS Trust to test how training and working closely with partners can improve local knowledge, identification of mental health issues and improve referrals to our services.

As well as this, input into individual behavior support plans, pastoral support meetings and inclusion meetings were provided. Training with mental health charity Rethink, was commissioned by the CCG in order to deliver mental health training to schools by young people. Direct 1-1 work with some young people and parents was offered where indicated. Through this pilot we made a difference by giving dedicated time to staff to feel supported and enriching them with knowledge about mental health, which can often be a subject that causes unease. Staff involved in this pilot emerged feeling more confident speaking about mental health issues and feel they could now access CAMHS to support students. We have made a difference by illuminating the pathway for teachers and allowing mental health to be at the forefront of their minds.

Wider Support

The Pilot was jointly funded and led by NHS England and the Department for Education and Hammersmith & Fulham CCG. We also worked closely with the Anna Freud Centre who were commissioned to develop and deliver the joint training programme. Our partner organisations also consisted of the schools that were involved in the pilot. All in all, we shared information and common interests, improved understanding of mental health and worked to mutual benefit. Our overall aims were the same, which we feel contributed hugely to the success of this pilot: improving access to mental health care for young children in need.

Co-Production

We asked for feedback after every session and the school leads gathered feedback from teachers and students. School staff also gave feedback about the pilot via a specially devised tool, and some CYP IAPT measures.

Looking Back/Challenges Overcome

With a pilot project like this, there is always room for reflection and learning. Some of our head teachers and senior managers did not prioritise psychological well-being amongst staff and students, which made finding time to deliver training or offer consultation spaces more difficult. Perhaps we could have emphasised the extent and gravity of mental health difficulties that are common place in schools in order to engage these members of staff better.

Another challenge was that there were varying degrees of knowledge amongst staff so some participants felt that they already knew some of the information and others had little experience of working with mental health needs. In hindsight it would have been useful to more spend time understanding the staff’s knowledge and areas they wanted developing.

Sustainability

We know what works well and that is consultation, training and having a dedicated CAMHS link clinician. Unfortunately, funding for the project on a larger scale covering more schools in the borough is unavailable, but we are confident that the schools have increased knowledge, awareness, skills and expertise in relation to mental health issues, recognising signs and symptoms of mental health difficulties, and that they are clear about thresholds and referral pathways into child and adolescent mental health services.

We also have resources such as training packs and posters which can be used throughout other schools. Embedding self-help literature within schools as well as an up to date and meaningful school mental health policy ensures mental health is at the forefront of school staff’s mind.

Evaluation (Peer or Academic)

The evaluation of the pilot is being conducted by ECORYS. • The evaluation involves Schools, CAMHS and the CCG taking part in initial and follow up surveys. • We also measured the success of the pilot scheme locally using the CASCADE measure. We have analysed the data across three time-points.

Outcomes

Our Qualitative Feedback mirrored the positive findings from our surveys, and also revealed areas for development:

•”it felt like fulfilling the need of sharing thoughts, concerned and practices” •”I was able to attend the meeting for a short period of time, but I found it very useful – a lot of feedback ideas from objective members of staff” •”Very good, but I would have much preferred a long session – thank you” •”It would be great to spend a day on this” •”Excellent sessions, individual reflective practice and mindfulness” •”Interestingly we talked about this being a partnership project and I asked XXX (CCAMHS clinician) to use the form to give me feedback on ‘how was the meeting for her?’. It would be interesting to have this data/feedback each time too.” •”Very useful” •”I felt listened and understood. Useful tips to follow” •”Within school framework, some ideas are a bit tricky to implement, but definite food for thought”

We were able to draw from this that school staff increased confidence when dealing with mental health issues. They found our presence reassuring and beneficial with regards to providing an extra layer of support and advice for both the link worker as well as disseminated throughout the wider school staff. Staff overall feedback that they felt that they had a better understanding of CAMHS referral criteria, and enjoyed getting feedback from CAMHS regarding clients and their families.

This project has also allowed us to evaluate and strengthen existing pastoral support systems for schools, for example, one school updated their self-harm policy has with input and advice from CAMHS. We also increased staff knowledge and awareness of the range of services that CAMHS offers and how best to access them, and the range of mental health needs within schools.

Sharing

We shared our learning from the project at a schools conference, in our team meetings and we will be having a celebration event to mark the end of the project on the 24th of May where all of the schools who took part in the pilot will be invited to attend. We have also shared our learning via joint training days with the pilot schools and with other pilot sites.

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This site is supported by the Positive Practice in MH Collaborative, Breakthrough MH Ltd, the National Collaborating Centre for Mental Health and Otsuka Health Solutions